Benefit of treatment of latent tuberculosis infection in individual patients

Dobler, Claudia C.; Martin, Andrew; Marks, Guy B.

doi:10.1183/13993003.00175-2016

Cited by 7 publications

(4 citation statements)

References 7 publications

(6 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We defined a country of origin as having a high TB burden if it had a TB incidence >200/100 000 people, and limited this potential screening population to people migrating to BC at age ≤50 years. We selected these age and incidence cut-points based on the estimated threshold whereby LTBI treatment would benefit an individual in quality-adjusted life years [6,21]. In other words, in this cohort, people at these cut-points had active TB incidences exceeding the threshold for an individual benefit of LTBI therapy.…”

Section: Identification Of Ltbi Screening Factors and Active Tuberculosis Outcomesmentioning

confidence: 99%

Estimated Impact of World Health Organization Latent Tuberculosis Screening Guidelines in a Region With a Low Tuberculosis Incidence: Retrospective Cohort Study

Ronald

Campbell²,

Rose

et al. 2019

Clinical Infectious Diseases

View full text Add to dashboard Cite

Background Latent tuberculosis infection (LTBI) screening and treatment is a key component of the World Health Organization (WHO) EndTB Strategy, but the impact of LTBI screening and treatment at a population level is unclear. We aimed to estimate the impact of LTBI screening and treatment in a population of migrants to British Columbia (BC), Canada. Methods This retrospective cohort included all individuals (N = 1 080 908) who immigrated to Canada as permanent residents between 1985 and 2012 and were residents in BC at any time up to 2013. Multiple administrative databases were linked to identify people with risk factors who met the WHO strong recommendations for screening: people with tuberculosis (TB) contact, with human immunodeficiency virus, on dialysis, with tumor necrosis factor-alpha inhibitors, who had an organ/haematological transplant, or with silicosis. Additional TB risk factors included immunosuppressive medications, cancer, diabetes, and migration from a country with a high TB burden. We defined active TB as preventable if diagnosed ≥6 months after a risk factor diagnosis. We estimated the number of preventable TB cases, given optimal LTBI screening and treatment, based on these risk factors. Results There were 16 085 people (1.5%) identified with WHO strong risk factors. Of the 2814 people with active TB, 118 (4.2%) were considered preventable through screening with WHO risk factors. Less than half (49.4%) were considered preventable with expanded screening to include people migrating from countries with high TB burdens, people who had been prescribed immunosuppressive medications, or people with diabetes or cancer. Conclusions The application of WHO LTBI strong recommendations for screening would have minimally impacted the TB incidence in this population. Further high-risk groups must be identified to develop an effective LTBI screening and treatment strategy for low-incidence regions.

show abstract

Section: Identification Of Ltbi Screening Factors and Active Tuberculosis Outcomesmentioning

confidence: 99%

Estimated Impact of World Health Organization Latent Tuberculosis Screening Guidelines in a Region With a Low Tuberculosis Incidence: Retrospective Cohort Study

Ronald

Campbell²,

Rose

et al. 2019

Clinical Infectious Diseases

View full text Add to dashboard Cite

show abstract

“…To date, the effectiveness (in particular the cost-effectiveness) of such programmes remains unclear, since many high-risk migrants do not attend routine follow-up visits [17]. It seems reasonable to consider LTBI treatment as an alternative or as an addition to chest radiograph follow-up, as the benefit of LTBI treatment for high-risk groups is well documented [77,78].…”

Section: Post-migration Follow-upmentioning

confidence: 99%

Screening for tuberculosis in migrants and visitors from high-incidence settings: present and future perspectives

et al. 2018

Self Cite

View full text Add to dashboard Cite

In most settings with a low incidence of tuberculosis (TB), foreign-born people make up the majority of TB cases, but the distribution of the TB risk among different migrant populations is often poorly quantified. In addition, screening practices for TB disease and latent TB infection (LTBI) vary widely. Addressing the risk of TB in international migrants is an essential component of TB prevention and care efforts in low-incidence countries, and strategies to systematically screen for, diagnose, treat and prevent TB among this group contribute to national and global TB elimination goals.This review provides an overview and critical assessment of TB screening practices that are focused on migrants and visitors from high to low TB incidence countries, including pre-migration screening and post-migration follow-up of those deemed to be at an increased risk of developing TB. We focus mainly on migrants who enter the destination country application for a long-stay visa, as well as asylum seekers and refugees, but briefly consider issues related to short-term visitors and those with long-duration multiple-entry visas. Issues related to the screening of children and screening for LTBI are also explored.

show abstract

“…Treating high risk migrants for LTBI, once TB disease has been ruled out, should benefit individual migrants and the general public [56], although formal cost effectiveness analyses remain limited. A systematic review of 16 studies on LTBI screening among migrants did not arrive at any definite conclusions about the (cost-) effectiveness of this intervention [57].…”

Section: Ltbi Screeningmentioning

confidence: 99%

Tuberculosis in migrants – screening, surveillance and ethics

et al. 2020

Self Cite

View full text Add to dashboard Cite

Tuberculosis (TB) is the leading infectious cause of human mortality and is responsible for nearly 2 million deaths every year. It is often regarded as a 'silent killer' because it predominantly affects the poor and marginalized, and disease outbreaks occur in 'slow motion' compared to Ebola or coronavirus 2 (COVID-19). In low incidence countries, TB is predominantly an imported disease and TB control in migrants is pivotal for countries to progress towards TB elimination in accordance with the World Health Organisations (WHO's) End TB strategy. This review provides a brief overview of the different screening approaches and surveillance processes that are in place in low TB incidence countries. It also includes a detailed discussion of the ethical issues related to TB screening of migrants in these settings and the different interests that need to be balanced. Given recognition that a holistic approach that recognizes and respects basic human rights is required to end TB, the review considers the complexities that require consideration in low-incidence countries that are aiming for TB elimination.

show abstract

Benefit of treatment of latent tuberculosis infection in individual patients

Cited by 7 publications

References 7 publications

Estimated Impact of World Health Organization Latent Tuberculosis Screening Guidelines in a Region With a Low Tuberculosis Incidence: Retrospective Cohort Study

Estimated Impact of World Health Organization Latent Tuberculosis Screening Guidelines in a Region With a Low Tuberculosis Incidence: Retrospective Cohort Study

Screening for tuberculosis in migrants and visitors from high-incidence settings: present and future perspectives

Tuberculosis in migrants – screening, surveillance and ethics

Contact Info

Product

Resources

About